Acromegaly

Acromegaly is a rare hormonal condition in which the body produces too much growth hormone, usually because of a benign tumour of the pituitary gland. When it starts in adults, bones, cartilage, and soft tissues grow gradually — typically the hands, feet, and face. When it starts in children before their growth plates close, it causes gigantism.

Symptoms

Changes develop slowly over years, so they're often missed until the condition is advanced:

• Enlarged hands and feet — rings, shoes, or hats no longer fit
• Coarsening of facial features — enlarged nose, brow, jaw; wider gaps between teeth
• Joint pain, carpal tunnel syndrome
• Fatigue, weakness
• Excessive sweating, oily skin, skin tags
• Deepening voice
• Headaches, vision changes (if the tumour presses on nearby nerves)
• Irregular periods, reduced sex drive, erectile dysfunction

Acromegaly also raises the risk of high blood pressure, diabetes, heart disease, and sleep apnoea.

Diagnosis

• Blood tests — insulin-like growth factor 1 (IGF-1), growth hormone levels after an oral glucose challenge
• MRI of the pituitary gland
• Additional tests for complications (blood pressure, blood sugar, heart, sleep study)

Treatment

Treatment aims to reduce growth-hormone levels and shrink or remove the tumour:

• Surgery — usually via the nose (transsphenoidal) — to remove the pituitary tumour
• Medicines — to lower growth-hormone levels, used when surgery isn't possible or isn't fully successful
• Radiation therapy — for tumours that can't be fully removed or controlled with medicines

With treatment, most symptoms improve; bone changes are often permanent but stop progressing. Long-term follow-up is needed because the condition can recur.